Active NPI
Holly Joy Buerosse
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1255813036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05007063A
- Practice address
- 7301 E 16TH St
Indianapolis, IN 46219-2308 - Phone
- (317) 353-1290
- NPI assigned
- Aug 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05007063A | IN | Primary |
Addresses
Primary practice location
7301 E 16TH St
Indianapolis, IN 46219-2308
Mailing address
10845 Tealpoint Dr
Indianapolis, IN 46229-3436
Phone (317) 289-6168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05007063A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1255813036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10845 TEALPOINT DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462293436",
"telephone_number": "317-289-6168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7301 E 16TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462192308",
"telephone_number": "317-353-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUEROSSE",
"first_name": "HOLLY",
"middle_name": "JOY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-29",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05007063A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.